Provider Demographics
NPI:1649379728
Name:GARSKE OROTHOPAEDICS PC
Entity Type:Organization
Organization Name:GARSKE OROTHOPAEDICS PC
Other - Org Name:GARSKE ORTHOPEDICS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:T
Authorized Official - Last Name:GARSKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-784-8330
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:1010 MEDICAL CENTER DR SUITE 240
Mailing Address - City:HARDEEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29927
Mailing Address - Country:US
Mailing Address - Phone:843-784-8330
Mailing Address - Fax:843-784-8334
Practice Address - Street 1:1010 MEDICAL CENTER DR STE 240
Practice Address - Street 2:
Practice Address - City:HARDEEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29927
Practice Address - Country:US
Practice Address - Phone:843-784-8330
Practice Address - Fax:843-784-8334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22882207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC228827Medicaid
SC8226Medicare PIN
SC228827Medicaid